Individual provider Active NPI

Christina Susanne Johnson, FNP-C

  • Family Nurse Practitioner
  • Peoria, AZ
National Provider Identifier
1376858746
Registry record updated Jul 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
317529 Issued in AZ
Practice address
11749 W Lone Mountain Pkwy Unit 105
Peoria, AZ 85383-6801
Phone
(480) 677-8282
Fax
(844) 470-2777
NPI assigned
Aug 10, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X C-APN.0103396-C-NP CO
Family Nurse Practitioner 363LF0000X AP61635778 WA
Family Nurse Practitioner 363LF0000X 13794235-4405 UT
Family Nurse Practitioner 363LF0000X RN176056 GA
Family Nurse Practitioner 363LF0000X 101.0137534 VT
Family Nurse Practitioner 363LF0000X TPAN2704 FL
Family Nurse Practitioner 363LF0000X APRN.CNP.0038228 OH
Family Nurse Practitioner 363LF0000X 317529 AZ Primary

Addresses

Primary practice location

11749 W Lone Mountain Pkwy Unit 105
Peoria, AZ 85383-6801

Mailing address

261 N Roosevelt Ave
Chandler, AZ 85226-2617
Phone (480) 677-8282

Other identifiers 1

IdentifierTypeStateIssuer
171842MedicaidAZ

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Good Health Medical PLLC 215 clinicians

Practice addresses (Care Compare)

240 N E Promontory Ofc
Suite 228
Farmington, UT 84025-2950
Phone (801) 631-3570

7435 W Cactus Rd
Suite a 125
Peoria, AZ 85381-5300
Phone (480) 677-8282

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, UT, AZ3 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20101104001234 GA Practitioner - Nurse Practitioner 6507050309 Reassigns benefits to 1 organization
I20250109001955 UT Practitioner - Nurse Practitioner 6507050309 Reassigns benefits to 2 organizations
I20250311002767 AZ Practitioner - Nurse Practitioner 6507050309 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
317529AZMDFamily Nurse Practitioner
C-APN.0103396-C-NPCOMDFamily Nurse Practitioner
TPAN2704FLMDFamily Nurse Practitioner
APRN.CNP.0038228OHMDFamily Nurse Practitioner
13794235-4405UTMDFamily Nurse Practitioner
101.0137534VTMDFamily Nurse Practitioner
AP61635778WAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Current Accepting new patients
Crystal Health Solutions Michigan LLC CurrentSince Nov 2, 2024 Accepting new patients
Ihc Health Services, Inc. CurrentSince Feb 17, 2025 Accepting new patients
Ihc Health Services Inc CurrentSince Feb 17, 2025 Accepting new patients
Theramed Health, LLC CurrentSince Oct 16, 2018 Accepting new patients
Good Health Medical, PLLC CurrentSince Mar 15, 2025 Accepting new patients
Good Health Medical, PLLC Current Accepting new patients
Good Health Medical, PLLC CurrentSince Mar 15, 2025 Accepting new patients
Good Health Medical, PLLC Past Accepting new patients
Good Health Medical, PLLC Past Accepting new patients

Locations

261 N Roosevelt Ave
Chandler, AZ 85226
Phone (480) 305-2888

428 S Gilbert Rd
Ste 101
Gilbert, AZ 85296
Phone (480) 632-7400

1121 S Higley Rd
Ste 106
Mesa, AZ 85206

11749 W Lone Mountain Pkwy
Unit 105
Peoria, AZ 85383

7435 W Cactus Rd
Ste A125
Peoria, AZ 85381

287 E Hunt Hwy
Ste 105
San Tan Valley, AZ 85143
Phone (480) 667-8282

3950 Cobb Pkwy NW
Ste 401
Acworth, GA 30101
Phone (404) 857-9575

3250 Quick Water Lndg NW
Kennesaw, GA 30144
Phone (404) 857-9575

240 N East Promontory
Ofc 228
Farmington, UT 84025
Phone (801) 631-3570

240 N East Promontory
Ofc
Farmington, UT 84025
Phone (801) 631-3570

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

721 N Main St
Layton, UT 84041

1424 E Foremaster Dr
Ste 140
St George, UT 84790
Phone (435) 251-2888

Interoperability endpoints

  • FHIR API: https://epicproxy.et4001.epichosted.com/APIProxyPRD/MDN/api/FHIR/R4

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751328000000",
    "number": "1376858746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 N ROOSEVELT AVE",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852262617",
            "telephone_number": "480-677-8282",
            "fax_number": "844-470-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11749 W LONE MOUNTAIN PKWY UNIT 105",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853836801",
            "telephone_number": "480-677-8282",
            "fax_number": "844-470-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTINA",
        "middle_name": "SUSANNE",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-10",
        "last_updated": "2025-07-01",
        "certification_date": "2025-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CO",
            "license": "C-APN.0103396-C-NP",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61635778",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "13794235-4405",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN176056",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VT",
            "license": "101.0137534",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "TPAN2704",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.0038228",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "317529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171842",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.